Risk-Stratified Venous Thromboembolism Prophylaxis After Total Joint Arthroplasty: Aspirin and Sequential Pneumatic Compression Devices vs Aggressive Chemoprophylaxis

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• 作者：Khalid Odeh ; BA ; James Doran ; MD ; Stephen Yu ; MD ; Nicholas Bolz ; BS ; Joseph Bosco ; MD ; Richard Iorio ; MD
• 关键词：venous thromboembolism ; pulmonary embolism ; deep venous thrombosis ; risk stratification ; cost
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：31
• 期：9_supp_S
• 页码：78-82
• 全文大小：517 K

文摘

Venous thromboembolism (VTE) is a major concern after total joint arthroplasty (TJA). We evaluated a risk-stratified prophylaxis protocol for patients undergoing TJA.

absSec_2">Methods

abspara0015">A total of 2611 TJA patients were retrospectively studied. Patients treated with an aggressive VTE chemoprophylaxis protocol were compared with patients treated with a risk-stratified protocol utilizing aspirin and sequential pneumatic compression devices (SPCDs) for standard-risk patients and targeted anticoagulation for high-risk patients.

absSec_3">Results

abspara0020">We found equivalence in terms of VTE prevention between the 2 cohorts. There was a decrease in adverse events and readmissions among the risk-stratified cohort, although this did not reach statistical significance. A statistically significant reduction in costs (P < .001) was experienced with the use of aspirin/SPCDs compared with aggressive anticoagulation agents within the risk-stratified cohort.

absSec_4">Conclusion

abspara0025">The use of aspirin/SPCDs in a risk-stratified TJA population is a safe and cost-effective method of VTE prophylaxis.